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"Infeksi pada pasien kanker payudara yang menerima kemoterapi mielosupresif mengakibatkan kebutuhan akan hospitalisasi sehingga meningkatkan biaya kesehatan. Pemberian seftazidim dapat mempersingkat durasi neutropenia dan lama hari rawat inap. Analisis efetivitas-biaya (AEB) merupakan salah satu metode farmakoekonomi yang penting untuk menentukan obat efektif dengan biaya yang lebih rendah. Penelitian dilakukan untuk membandingkan total biaya medis langsung dan efektivitas yang dilihat dari lama hari rawat penggunaan seftazidim generik A dan B, serta menentukan seftazidim yang lebih cost-effective pada pasien kanker payudara stadium awal dan lanjut di Rumah Sakit Kanker Dharmais Jakarta tahun 2012. Desain penelitian yang digunakan adalah non eksperimental dengan studi perbandingan. Pengambilan data dilakukan secara retrospektif terhadap data sekunder berupa catatan rekam medik serta data administrasi tahun 2012. Pengambilan sampel dilakukan secara total sampling. Jumlah pasien yang dilibatkan dalam analisis sebanyak 9 pasien, yaitu 7 pasien menggunakan seftazidim generik A dan 2 pasien menggunakan seftazidim generik B. Median total biaya medis langsung kelompok generik A pada pasien kanker stadium awal maupun lanjut berturut-turut sebesar Rp Rp 15.930.407,45 dan Rp Rp 15.962.519,25, lebih tinggi dibanding generik B, berturut-turut sebesar Rp 6.716.225,21 dan Rp 7.147.956,92. Median lama hari rawat kelompok generik A pada pasien kanker stadium awal maupun lanjut berturut-turut 7 hari dan 10 hari, lebih panjang dibanding generik B, berturut-turut 3 hari dan 4 hari. Berdasarkan AEB diketahui seftazidim generik B lebih cost-effective dibanding generik A.

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Infections among breast cancer patients receiving myelosuppressive chemotherapy led to hospitalization thus increased the health cost. Early administration of ceftazidime shortened duration of neutropenia and hospitalization days. Cost-effectiveness analysis (CEA) as one of pharmacoeconomic methods was important to determine treatment attaining effect for lower cost. This study was conducted to compare the total direct medical cost and effectiveness, which was measured from length-of-stay (LOS), of ceftazidime generic A and B usage, and to decide which ceftazidime that was more costeffective in early-stage and late-stage breast cancer patients at National Cancer Center Dharmais Hospital Jakarta year 2012.

The study design was nonexperimental with comparative study. Data were collected retrospectively on secondary data from medical records and administrative data in 2012. Samples were taken by using total sampling method. The number of samples were 9 patients, which included 7 patients with ceftazidime generic A and 2 patients with ceftazidime generic B.

The total direct medical cost of ceftazidime generic A in early-stage and late-stage breast cancer patients, respectively Rp 15.930.407,45 and Rp 15.962.519,25, were higher than generic B, respectively Rp 6.716.225,21 and Rp 7.147.956,92. Median LOS of ceftazidime generic A in early-stage and late-stage breast cancer patients, respectively 7 days and 10 days, were longer than generic B, respectively 3 days and 4 days. According to CEA result, ceftazidime generic B was more cost-effective than generic A."

"Kejadian infeksi pasca pembedahan dan pasca kemoterapi pada pasien kanker payudara dapat memperpanjang lama rawat inap sehingga meningkatkan biaya kesehatan. Meningkatnya biaya pengeluaran kesehatan mendorong adanya evaluasi ekonomi. Analisis efektivitas-biaya (AEB) sebagai salah metode farmakoekonomi penting dilakukan untuk membandingkan antibiotik yang digunakan. Penelitian ini bertujuan untuk membandingkan total biaya penggunaan, efektivitas seftriakson generik A dan B, dan menentukan seftriakson yang lebih cost-effective untuk pasien kanker payudara di RS Kanker Dharmais tahun 2012. Desain penelitian ini adalah non eksperimental dengan studi perbandingan dan pengambilan data secara retrospektif menggunakan data sekunder dari rekam medis dan Sistem Informasi Rumah Sakit RS Kanker Dharmais. Pengambilan sampel dilakukan secara total sampling. Jumlah sampel sebanyak 16 pasien untuk seftriakson generik A dan 8 pasien untuk generik B.Efektivitas seftriakson pada indikasi pasca pembedahan untuk generik A sebesar 2,5 hari dan untuk generik B sebesar 1,0 hari, sedangkan pada indikasi pasca kemoterapi untuk generik sebesar 4,0 hari dan untuk generik B sebesar 9,5 hari. Total biaya penggunaan seftriakson pada indikasi pasca pembedahan untuk generik A sebesar Rp 4.384.448,00 dan untuk generik B sebesar Rp 3.397.952,00,sedangkan pada indikasi pasca kemoterapi untuk generik A sebesar Rp2.284.655,00 dan untuk generik B sebesar Rp 11.195.270,00. Berdasarkan AEB,pada indikasi pasca pembedahan diperoleh hasil seftriakson generik B lebih costeffective daripada generik A, sedangkan pada indikasi pasca kemoterapi diperoleh hasil seftriakson generik A lebih cost-effective daripada generik B.

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The incidence of post-surgery and post-chemotherapy infections in breast cancer patients prolonged the hospitalization days leading to the increase of health costs.The increasing health expenditure demanded the use of economic evaluation.Cost-effectiveness analysis (CEA) as one of pharmacoeconomics methods was important to compare the usage of antibiotics. The purposes of this research were to compare total cost and effectiveness of using generic ceftriaxone A and B, and to decide which ceftriaxone that was more cost-effective in breast cancer patients in Dharmais Cancer Hospital during 2012. Effectiveness was measured as ceftriaxone-using days, meanwhile cost was measured as total direct medical cost.

The research design was non experimental with comparative study and retrospective data were collected from medical records and hospital information systems of Dharmais Cancer Hospital. Samples were taken by using total sampling method. There were 6 patients using generic ceftriaxone A and 8 generic ceftriaxone B. Effectiveness of ceftriaxone for post-surgery indication in generic ceftriaxone A was 2,5 days and in generic B was 1,0 days, meanwhile for postchemotherapy indication in generic A was used 4,0 days and in generic B was 9,5 days.

Total direct medical cost of ceftriaxone for post-surgery indication in generic A and B, respectively Rp 4.384.448,00 and Rp 3.397.952,00, meanwhile for post-chemotherapy indication in generic A and B, respectively Rp 2.284.655,00 and Rp 11.195.270,00. According to CEA result, it could be concluded that generic ceftriaxone B was more cost-effective than A for postsurgery indication, meanwhile generic ceftriaxone A was more cost-effective than B for post-chemotherapy indication."

"Mual dan muntah akibat kemoterapi merupakan salah satu efek samping yang dapat menurunkan kualitas hidup pasien. Antagonis reseptor 5-HT3 seperti ondansetron telah digunakan dalam mengontrol mual dan muntah akibat kemoterapi emetogenik moderat. Perbedaan biaya obat antara ondansetron generik berlogo dan bermerek dagang diketahui cukup signifikan. Metode analisis efektivitas-biaya (AEB) dilakukan untuk mengukur dan membandingkan efektivitas serta biaya antara kedua pengobatan. Penelitian ini merupakan penelitian observasional dengan pengambilan data secara retrospektif. Pengambilan sampel dilakukan secara total sampling. Data primer dan sekunder didapatkan melalui catatan rekam medik, sistem informasi rumah sakit, dan wawancara. Pasien wanita dengan kanker payudara yang menggunakan kemoterapi emetogenik moderat untuk pertama kalinya di RS Kanker Dharmais pada tahun 2012 diikutsertakan dalam penelitian. Sampel yang dilibatkan dalam analisis sebanyak 21 pasien, yaitu 12 pasien ondansetron generik berlogo dan 9 pasien ondansetron generik bermerek dagang. Efektivitas pengobatan diukur berdasarkan proporsi pasien yang terbebas dari mual dan muntah akut. Biaya didapatkan dari median total biaya pengobatan, meliputi biaya obat, alat kesehatan, rawat singkat, dan jasa dokter. Berdasarkan hasil penelitian, efektivitas ondansetron generik bermerek dagang lebih besar (0,444) dibandingkan ondansetron generik berlogo (0,250). Median total biaya pengobatan ondansetron generik bermerek dagang lebih mahal (Rp 468.649,00) dibandingkan ondansetron generik berlogo (Rp 405.022,00). Hasil akhir menunjukkan bahwa ondansetron generik bermerek dagang (REB: Rp 1.055.515,77) lebih cost-effective dibandingkan ondansetron generik berlogo (REB: Rp 1.620.088,00). Perpindahan pengobatan dari ondansetron generik berlogo ke bermerek dagang membutuhkan biaya tambahan sebesar Rp 327.974,23 agar terbebas resiko mual dan muntah akut akibat kemoterapi emetogenik moderat.

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Chemotherapy-induced nausea and vomiting (CINV) is one of the side effects that can reduce the quality of life. A 5-HT3 receptor antagonist like ondansetron has been used to control moderately emetogenic chemotherapy induced-nausea and vomiting. Difference in drug costs between ondansetron generics and brand names appear significantly. Cost-effectiveness analysis (CEA) were conducted to measure and compare the effectiveness and cost of the treatment.

A observasional study was done using total sampling method from retrospective data. Primary and secondary data collected from medical records, hopital information systems, and interviews. Female patients with breast cancer who were prescribed moderately emetogenic chemotherapy for the first time in 2012 were included in this research. The number of samples were 21 patients, which included 12 patients with generics ondansetron and 9 patients with brand names ondansetron. The effectiveness is measured by the proportion of patients free of acute nausea and vomiting. The cost is median of the total cost, summed from the cost of drugs, medical devices, hospitalization, and physician.

Based on the results of this study, the effectiveness of brand names ondansetron (0.444) is greater than generics ondansetron (0.250). Median total cost of brand names ondansetron is more expensive (Rp 468,649.00) than generics ondansetron (Rp 405,022.00). The final result showed that brand names ondansetron (CER: Rp 1,055,515.77) is more cost-effective than generics ondansetron (CER: Rp 1,620,088.00). Change of medication from generics to brand names ondansetron require extra cost Rp 327,974.23 for controlling acute nausea and vomiting due to moderately emetogenic chemotherapy."

"Ovarian cancer is one of the largest cause of death in women. It is often refered to as the silent killer because the symtoms remain unseen to the patient. The number of ovarian cancer cases varies in each country. For example, the rate of ovarian cancer in counties such as Asia and Africa lower rather than in most industrialized countries like Europe and North America, Rate of Epithelial ovarian cancer in women ages 45-49 was 16.4 cases per 100,000 people. The risk of being diagnosed increases with age. The risk more than doubles in women 60 and over with 40 cases per 100,000, and the highest rate at 61 cases to 100,000 is in the age group of women 80-84. Currently, informaiion regarding ovarian cancer in Indonesia is limited, but Dharmais Cancer Hospital found about 30 new cases of ovarian caricer every year. The purpose of this study is to determine the probability of serum albumin levels in the survivors of epithelial ovarian cancer at Dharmais Cancer Hospital in Jakarta in 1996-2004. Design study is retvospective cohort usirg secondary data epithelial ovarian cancer patients at Dharmais Cancer Hospital. The study uses observations of 48 patients from the time of their diagnotion until they are cured, their death or they lost to follow up. The data were analyzed using survival analysis. The resu!ts shows that overall probability five-year survival in patients with epithelial ovarian cancer at the Dharmais Cancer Hospital Jakarta in 1996-2004 is 26.2%. the probability of patients surviving five years on the serum albumin with > 3.6 mg / dl was 36.1% whichis higher than those of patients with serum albumin <3.6 mg / di at 15.7%. After controled by stage of the cancer, the ascites and hemoglobin levels of the patients with an albumin level of < 3.6 mg / dl had a risk of death 7.979 times higher than with an a!tumin fevel > 3.6 mg / dl. "

"Golongan antrasiklin merupakan kemoterapi pilihan pertama untuk penanganan kanker payudara, khususnya pada pasien lanjut usia. Namun beberapa penelitian melaporkan terkait kejadian tidak diharapkan pada penggunaan antrasiklin. Penelitian ini dilakukan bertujuan untuk mengidentifikasi kejadian tidak diharapkan. Selain itu untuk mengetahui hubungan variabel bebas terhadap kejadian tidak diharapkan pada penggunaan rejimen berbasis antrasiklin. Penelitian ini merupakan penelitian observasional dengan rancang penelitian potong lintang (cross-sectional).  Pengambilan sampel dilakukan secara retrospektif, pada pasien lanjut usia (≥60 tahun) di Rumah Sakit Kanker Dharmais. Pengambilan data mulai Januari 2018-Desember 2020. Identifikasi kejadian tidak diharapkan dari penggunaan kemoterapi berbasis antrasiklin menggunakan metode trigger tool khusus untuk pasien kanker. Analisis statistik digunakan untuk memperoleh karakteristik variabel bebas, selain itu untuk mengetahui hubungan variabel bebas terhadap kejadian tidak diharapkan. Pada 107 subjek, sebanyak 71% (n=76 pasien) teridentifikasi dengan trigger tool, seluruh subjek mengalami 122 trigger.rigger pemberian transfusi darah paling banyak ditemukan pada penelitian ini, yaitu pada 39% (n=30 pasien). Netropenia dan anemia merupakan KTD terbanyak yang teridentifikasi pada penggunaan kemoterapi berbasis antrasiklin. Seluruh KTD yang teridentifikasi merupakan kategori E sebanyak 251 kejadian. Pemberian transfusi darah merupakan variabel bebas yang mempunyai hubungan signifikan (p<0,05) dengan kejadian tidak diharapkan dari penggunaan kemoterapi berbasis antrasiklin pada pasien lanjut usia kanker payudara.

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Anthracycline are the first choice chemotherapy for the treatment of breast cancer, particularly in elderly patients. However, several studies reported adverse events in the treatment of using anthracyclines. This study aims to identify adverse events. Furthermore, to find out more about how independent variables related to adverse event. An observational retrospective study of elderly patient (≥ 60 years) was conducted in a tertiary cancer hospital in Jakarta. Data were collected from January 2018 to December 2020. We used trigger tool specific for cancer patients to identify adverse event during anthracycline base regimen. Independent variables were evaluated in univariate analysis: age, weight loss, marital status, total cumulative dose, polypharmacy, types of anthracycline, metastatic status. Bivariate and multivariate analysis to find out relationship between independent variable and adverse event. In total, 107 subject records were collected and reviewed, there were 71% (n=76 patients) identified with trigger tool. Trigger were totally identified 122 times in 86 medical records. Neutropenia and anemia were the most common adverse events identified in our study. Adverse events with category E identified in all of the subject, as many as 251 events. Blood transfusion had significantly relationship (p<0,05) with adverse events in elderly breast cancer patients."

"Analisa Biaya Satuan Tindakan Terapi Radiasi EksternalPada Pasien Kanker Payudara di Instalasi Radioterapi RS.Kanker Dharmais Tahun 2016 rdquo;.Angka kasus kanker payudara di Indonesia, tinggi. Kunjungan pasien kankerpayudara ke RS Kanker Dharmais mengalami peningkatan. Terapi Radiasi eksternaltermasuk layanan unggulan untuk pengobatan kanker payudara di RS. Kanker Dharmais.Pemerintah membiayai tindakan terapi ini lewat tarif INA CBG rsquo;s sebesar Rp 1.014.906.Melalui metode perhitungan Activity Based Costing ABC , peneliti ingin mengetahuiberapa sebenarnya biaya satuan tindakan untuk terapi ini ; lalu dibandingkan dengan tarifINA CBG rsquo; s yang berlaku.Hasil penelitian menunjukkan bahwa total biaya tindakan 1 siklus terapi radiasieksternal kanker payudara di RS Kanker Dharmais tahun 2016 adalah sebesar Rp36.482.930, dengan biaya satuan tindakan sebesar Rp 1.216,098,-Name Aurora SihombingStudy Program Health EconomicsTitle of Research Analysis of Unit Cost of External Radiation Therapy forBreast Cancer Patient of Radiotherapy Installation atRumah Sakit Kanker Dharmais in 2016.The number of breast cancer cases in Indonesia is at alarming rate. Breastcancer patients looking for treatment at Rumah Sakit Kanker Dharmais havecontinually increased for the last several years. The external radiation therapy ofRumah Sakit Kanker Dharmais has been considered as one of the best cancertreatment facilities in the country. Indonesian government subsidizes cost of thetherapy based on INA CBG rsquo s tariff scheme of Rp 1.014.906. Using ActivityBased Costing ABC approach, the researcher would like to investigate the realunit cost of the treatment the result will then be compared to the INA CBG rsquo stariff.The study showed that the total cost of one cycle of the external radiationtherapy for breast cancer at Rumah Sakit Kanker Dharmais is Rp36.482.930 in2016, while the unit cost is Rp 1.216,098, for the same periode."

"Doksorubisin merupakan salah satu terapi antikanker yang termasuk golongan antrasiklin, memiliki aktivitas klinis pada penyakit kanker payudara. Doksorubisin dapat menimbulkan efek kardiotoksik akibat pembentukan doksorubisinol selaku metabolit utamanya. Salah satu metode biosampling terbaru yaitu volumetric absorptive microsampling memiliki berbagai kelebihan yaitu pengambilan darah secara finger prick, tidak dipengaruhi oleh hematokrit, dan dapat disimpan dalam suhu ruang. Penelitian ini bertujuan untuk menganalisis doksorubisin dan mengetahui reaksi obat merugikan kemoterapi berbasis doksorubisin. Nilai multiple reaction monitoring (MRM) diatur pada m/z 544,22>396,9 untuk doksorubisin; m/z 546,22>398,9 untuk doksorubisinol; dan m/z 528,5>362,95 untuk daunorubisin. Nilai LLOQ yang diperoleh adalah 8 ng/mL untuk doksorubisin dan 3 ng/mL untuk doksorubisinol dengan linearitas 0,9904 untuk doksorubisin dan 0,9902 untuk doksorubisinol. Hasil analisis mendapatkan rentang kadar terukur untuk doksorubisin sebesar 9,47 – 87,84 ng/mL serta rentang kadar terukur untuk doksorubisinol sebesar 4,24 – 54,02 ng/mL. Dosis kumulatif doksorubisin pada pasien sebesar 47,93 – 346,09 mg/m2, hal ini menunjukkan bahwa risiko seluruh pasien terkena kardiomiopati di bawah angka kejadian 4%. Pasien yang mengalami penurunan fraksi ejeksi ventrikel kiri setelah kemoterapi doksorubisin terdiri dari penurunan fraksi ejeksi <10% dan ada 3 pasien yang mengalami penurunan fraksi ejeksi ventrikel kiri >10%. Alopesia merupakan reaksi obat merugikan subjektif yang paling banyak dirasakan pasien diikuti dengan mual dan muntah. Hasil uji hubungan menunjukkan adanya tidak signifikan antara kadar doksorubisin dan doksorubisinol terhadap reaksi obat merugikan pada pasien kanker payudara. Terdapat hubungan signifikan pada kadar doksorubisin terhadap dosis kumulatif dan waktu pengambilan sampel pasien.

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Doxorubicin is an anticancer therapy belonging to the anthracycline class, which has clinical activity in breast cancer. Doxorubicin can cause cardiotoxic effects due to the formation of doxorubicinol as its main metabolite. One of the newest biosampling methods, namely Volumetric Absorptive microsampling, has many advantages, namely blood collection by finger prick, not affected by hematocrit, and can be stored at room temperature. This study aims to analyze doxorubicin and determine the adverse drug reactions of doxorubicin-based chemotherapy. The multiple reaction monitoring (MRM) value is set at m/z 544.22> 396.9 for doxorubicin; m/z 546.22>398.9 for doxorubicinol; and m/z 528.5>362.95 for daunorubicin. The LLOQ values ​​obtained were 8 ng/mL for doxorubicin and 3 ng/mL for doxorubicinol with a linearity of 0.9904 for doxorubicin and 0.9902 for doxorubicinol. The results of the analysis showed that the measured concentration range for doxorubicin was 9.47 – 87.84 ng/mL and the measured concentration range for doxorubicin was 4.24 – 54.02 ng/mL. The cumulative dose of doxorubicin in patients was 47.93 – 346.09 mg/m2, this shows that the risk of all patient developing cardiomyopathy is below the incidence rate of 4%. Patients who experienced a decrease in left ventricular ejection fraction after doxorubicin chemotherapy consisted of a decrease in ejection fraction <10% and there were 3 patients who experienced a decrease in left ventricular ejection fraction >10%. Alopecia is the most common subjective adverse drug reaction experienced by patients, followed by nausea and vomiting. The results of the relationship test showed that there was no significant relationship between doxorubicin and doxorubicinol levels on adverse drug reactions in breast cancer patients. There is a significant relationship between doxorubicin levels and cumulative dose and patient sampling time.xv,"

"Kanker payudara merupakan salah satu tumor ganas pada jaringan payudara yang paling sering menyerang wanita dan menjadi salah satu penyakit serius di dunia yang mengancam jiwa. Insiden kanker payudara dilaporkan meningkat dari tahun ke tahun. Karya Ilmiah Akhir (KIA) ini adalah sebagai laporan praktik residensi keperawatan medikal bedah peminatan onkologi di RS Kanker Dharmais Jakarta yang berisi tentang: (1) penerapan teori Peaceful End of Life (PEOL) pada pasien kanker payudara, (2) intervensi menghirup aromaterapi jahe sebagai evidence based nursing untuk mengurangi mual muntah akibat kemoterapi pasien kanker payudara (3) proyek inovasi penggunaan Modified Early Warning Score (MEWS) sebagai alat deteksi awal terhadap perburukan kondisi pasien. Kesimpulan: bahwa teori Peaceful End Of Life tepat digunakan dalam perawatan paliatif pasien kanker. Intervensi menghirup aromaterapi jahe dapat digunakan sebagai salah satu alternatif pilihan manajemen mual muntah nonfarmakologi. Instrumen MEWS dapat diterapkan pada unit emergensi dan dapat membantu mengidentifikasi pasien dengan risiko perburukan kondisi yang membutuhkan peningkatan level perawatan seperti rawat inap atau masuk ICU.

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Breast cancer is a malignant tumor of the breast tissue that most often affects women and become one of serious diseases in the world and life-threatening. The incidence of breast cancer was reported increase year to year. This final paper clinical practice is a clinical report Medical Surgical nursing specialization in oncology at the Cancer Hospital Dharmais Jakarta which consist of : (1) the application of the theory of Peaceful End of Life (PEOL) in breast cancer patients, (2) intervention inhaling aromatherapy ginger as evidence based nursing to reduce nausea and vomiting due to chemotherapy in breast cancer patients (3) innovation projects implement the Modified Early Warning Score (MEWS) as a tools for early detection of the deterioration of the patient's condition. Conclusion: The theory of Peaceful End of Life is appropriate to use in the palliative care of cancer patients. Ginger aromatherapy can be used as an alternative nonpharmacological management of nausea and vomiting. MEWS instruments can be applied to the emergency unit and may help identify patients at risk to worsening condition require increased levels of care such as hospitalization or ICU. "

"Karya Ilmiah akhir KIA merupakan laporan praktik residensi keperawatan medikal bedah yang terdiri dari pengelolaan kasus kanker dengan pendekatan teori peaceful end of life, penerapan evidence based nursing self-management untuk mengurangi konstipasi pada pasien kanker payudara akibat kemoterapi yang mendapatkan antiemetik 5-hydroxytryptamine serotonin; 5HT3 yaitu ondansentron dan melakukan proyek inovasi kelompok tentang manajemen edukasi multimedia pada pasien kanker tiroid yang akan menjalani terapi radioaktive iodine RAI 131. Konsep peaceful end of life memberikan gambaran pada perawat untuk memberikan asuhan keperawatan paliatif pada pasien kanker. Self-management dapat digunakan sebagai salah satu terapi non farmakologi untuk mengurangi konstipasi, bersifat mudah dilakukan, aman dan secara teknis praktis untuk mengurangi konstipasi pada pasien kanker payudara karena tidak dibutuhkan keterampilan atau pelatihan khusus untuk melakukannya. Manajemen edukasi multimedia dapat memfasilitasi media edukasi pada pasien yang menjalani perawatan isolasi RAI 131, meningkatkan pengetahuan dan keterampilan perawat dalam manajemen edukasi pada pasien yang menjalani perawatan isolasi RAI 131.

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The final paper is a report of residency medical surgical nursing practice consisting of the management of the cancer cases with the approach of the peaceful end of life theory, application of evidence based nursing self management to reduce constipation in breast cancer patients due to chemotherapy who received antiemetic 5 hydroxytryptamine Serotonin 5HT3 in this case ondansentron and undertaking a group innovation project on multimedia education management in patients with thyroid cancer undergoing radioodine iodine RAI therapy 131. The concept of peaceful end of life provide an overview for nurses to provide palliative nursing care in cancer patients. Self management can be used as one of the non pharmacological therapies to reduce constipation, it is easy to do, safe and technically practical to reduce constipation in breast cancer patients since it does not require special skills or training to do so. Multimedia education management is able facilitate educational media in patients undergoing RAI 131 isolation treatments, improving nurse knowledge and skills in educational management in patients undergoing RAI 131 isolation treatments."

"Penggunaan siklofosfamid sebagai agen kemoterapi menyebabkan beberapa efek samping berupa mual, muntah, leukopenia, anemia, dan sistitis hemoragik. Efek samping yang disebabkan oleh siklofosfamid perlu mendapatkan perhatian dan penanganan khusus karena dapat membahayakan pasien. Penelitian ini bertujuan untuk menganalisis prevalensi kejadian mual, muntah, leukopenia, anemia, dan sistitis hemoragik pada pasien kanker yang mendapatkan kemoterapi siklofosfamid di Rumah Sakit Kanker Dharmais Jakarta periode Juli 2012 - Juli 2013. Metode penelitian yang digunakan adalah cross-sectional dan pengambilan data retrospektif dilakukan dengan menggunakan data rekam medik pasien. Sampel adalah pasien yang mendapatkan kemoterapi siklofosfamid di Rumah Sakit Kanker Dharmais Jakarta periode Juli 2012 - Juli 2013. Pengambilan sampel sebanyak 79 sampel dilakukan dengan total sampling. Berdasarkan hasil penelitian didapatkan prevalensi efek samping pada pasien yang mendapatkan kemoterapi siklofosfamid di Rumah Sakit Kanker Dharmais Jakarta periode Juli 2012 - Juli 2013 adalah mual (69,6%), muntah (50,6%), leukopenia (96,2%), anemia (87,3%), dan sistitis hemoragik (13,9%). Muntah dipengaruhi oleh dosis (p=0,000).

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Some of adverse drug reactions such as nausea, vomiting, leucopenia, anemia, and hemorrhagic cystitis caused cyclophosphamide as chemotherapy agents. The side effects caused by cyclophosphamide should get special attention and treatment because it can harm the patient. This research aimed to analyze the prevalence of nausea, vomiting, leucopenia, anemia, and hemorrhagic cystitis of patients treated with cyclophosphamide chemotherapy in Dharmais Cancer Hospital Jakarta period July 2012 - July 2013. The research design was cross-sectional and retrospective by using the patient's medical record. Samples were cancer patients who received cyclophosphamide chemotherapy in Dharmais Cancer Hospital Jakarta period July 2012 - July 2013. Sampling was carried out as many as 79 samples with a total sampling. Based on the results, the prevalence of side effects of patients treated with cyclophosphamide chemotherapy in Dharmais. Cancer Hospital Jakarta period July 2012 - July 2013 were nausea (69.6 %), vomiting (50.6 %), leucopenia (96.2 %), anemia (87.3 %), and hemorrhagic cystitis (13.9 %). Vomiting was influenced by dose (p=0,000)."